Healthcare Revenue Cycle Management Steps - OmniMD

1. OmniMD Cloud-based EHR solution designed for ambulatory outpatient clinics looking for EHR, Practice Management, and Medical Billing Software.

2. Introduction We are a leading provider of all-in-one electronic health records (EHR), practice management (PM), and revenue cycle management (RCM) solutions and services for medical practices. We have partnered with large and small medical practices, medical management organizations, and medical billing companies to improve patient and provider experience, optimize operations and maximize financial health.

3. Healthcare Revenue Cycle Management Steps • Design and Structure of RCM • Patient Eligibility and Verification • Co-Payment • Coding • Claim submission • Claim reimbursement • Review for any payment variances • Patient collections

4. Step 1: Design and Structure of RCM It's necessary to have a proper design and structure for an efficient revenue cycle management process. Some standard procedures and protocols have to be designed at the start to avoid any headaches in the long run. Depending on the size of your hospital and the availability of staff, you can choose to allocate the RCM process to your staff members or dedicate a separate team focused solely on the smooth working of RCM. OmniMD has proudly served providers for 20 years, giving you a thorough walkthrough with analytical dashboards and robust reporting for a quick and convenient way to analyze large volumes of data.

5. Step 2: Patient Eligibility and Verification Insurance companies do not cover certain medical services. To avoid any errors in the future, you have to verify the details on the patient's account to understand the medical services their insurance companies cover for the patient. Verification is the most significant phase of RCM.

6. Step 3: Co-Payment At the time of the medical service, the patient must pay from pocket any expenditure the insurance companies don't cover. As many healthcare systems fail to collect payments during this period, you have to get this out of the way before any medical service for the patient starts.

7. Step 4: Coding Coding is said to be the most critical step in RCM. The coders must be up-to-date with the latest changes in the coding guidelines from the federal authorities. Keep a close eye on CMS's 2022 Medicare and Medicaid updates so you don't miss out on any revenue.

8. Step 5: Claim submission Once everything is in place, it's time to fill out the claim form and submit it to the insurance companies. The RCM team reviews the charges, the CPT code, and the diagnosis code to avoid inconsistencies.

9. Step 6: Claim reimbursement When an insurance company receives a claim, they cross-check their database for the patient's policy and assign a reimbursement they deem fit. Any inconsistencies will lead to a decrease in the reimbursement amount.

10. Step 7: Review for any payment variances You will often get paid a different amount than the claims you submit to the insurance companies. This could be because of a lack of medical assistance or incorrect coding of the medical services. Check in with your insurance companies and re-submit any rectified claims. However, with OmniMD, you are in excellent hands and can avoid adverse events or inefficiencies with the claims at any given time.

11. Step 8: Patient collections The most challenging step of an RCM process is collecting the remaining due amount from the patients. You have to adequately explain their insurance coverage and the discrepancies and reasons for denied claims while remaining calm and supportive of the patient's condition. It's tedious, uncomfortable, and sometimes frustrating.

12. Contact Detail Address: 245 Sawmill River Road, Suite 301, Hawthorne, NY 10532 Phone: 1(844)666-4631, (914)332 5590 Email: marketing@omnimd.com, sales@omnimd.com Timings Mon-Fri: 8:00 AM to 8:00 PM EST Website:https://www.omnimd.com